NUR2633 – MCH – Study Guide Test 2: Module 3,4 and 5 (Labor, Postpartum and Newborn care),100% CORRECT
0 view 0 purchase
Course
NUR 2633
Institution
NUR 2633
NUR2633 – MCH – Study Guide Test 2: Module 3,4 and 5 (Labor, Postpartum and Newborn care),100%NUR2633 – MCH – Study Guide Test 2: Module 3 ,4 and 5 (Labor, Postpartum and Newborn care)
1. Know the Stages and phases of labor including the physiological changes, the normal progression
and t...
know the stages and phases of labor including the physiological changes
Written for
NUR 2633
All documents for this subject (148)
Seller
Follow
GEEKA
Reviews received
Content preview
GEANA
NUR2633 – MCH – Study Guide Test 2: Module 3 ,4 and 5 (Labor, Postpartum and Newborn care)
1. Know the Stages and phases of labor including the physiological changes, the normal progression
and the psychological impact to your patient. Know the labs that are essential to have for your
patient prior to delivery of baby.
There are four stages which are 1. Labor 2. Birth of baby, 3. Placenta delivery and 4. Recovery. In
the labor stage there are three phases.
Latent phase, which is variable, also the longest, mom will be between 0 and 4cm
dilated. Mom will be chatty, interactive. We want to help the uterus get food fluid and
rest during this period for next phases. Labor is active regular contractions that cause
cervical change. First thing we would do if a mom comes in is to hydrate her, IV Lactated
Ringers. She will be contracting between 10-15 minutes, possibly going down to 5
minutes.
Active phase, she will have more pain and more anxious, contractions will be 2-3
minutes apart, focused and can’t talk between her contractions, 4-7cm dilated, 1cm per
hour. There is a time stamp with the active phase of labor, 4-6 hours. If the active phases
goes longer than 6 hours there can be hypoxia to the baby and exhaustion to the
mother.
Transition phase, lasts 30 min to 2 hours, pain pressure scared restless. 8-10cm dilated,
feeling to push, There is a 2 hour timestamp on pushing except with an epidural we give
them 3 hours.
Stage 2 Birth of baby; When she becomes 10cm we know we are moving into the second
stage of labor. There are two ways to expel the baby vaginally, actively(Valsalva maneuver) or
nonvoluntarily(Ferguson’s response or reflex). Non pharmacological ways to birth the baby
are walking, changing positions
Stage 3 Placenta delivery should be 5-30 min after birth of baby, DO NOT PULL PLACENTA
OUT, make sure you inspect to make sure no infection and is intact
Stage 4 Recovery stage is 2 hours post delivery, assess lochia, fundus should be firm and at
or near umbilicus
2. Know the reasons and the findings of each vaginal exam.
Five things we can look for in a vaginal exam are effacement, dilation, station,
presentation, and rupture membranes. A patient is 380 and -2 that means she is 3 cm
dilated, 80% effaced and -2 means baby’s head is 2 cm above the ischial spine, in latent
phase. Remember +4 on the floor. If she is 890 and 0, then she is 8cm 90% effaced and
at the ischial spine, in active phase.
3. Know the medications of labor and when to administer them.
Pitocin(Oxytocin)- uterine contraction stimulant, induces labor, strengthen contractions,
causes a hypoxic environment for the baby, give Pitocin on a pump with a fetal monitor.
We titrate it in labor, we let it free flow after birth to let the uterus contract. If this
This study source was downloaded by 100000832361371 from CourseHero.com on 02-17-2022 00:01:03 GMT -06:00
, doesn’t work we try methergine, but its contraindicated in hypertension or preeclamptic
patient.
Magnesium Sulfate- give 24hrs after baby is born
Cervical ripeners- Cervidil, help dilate the cervix
Cytotec(Misoprostol)- stop post-partum hemorrhage
Methylergonovine(Methergine)- prevention and control of post-partum hemorrhage
Hemabate(Carboprost)- reduces post-partum bleeding, has nasty side effects
4. Know the risks of rupturing membranes and what is the nursing intervention if this occurs
spontaneously vs artificially.
Risks are Infection and prolapse cord.
SROM-spontaneous rupture of membranes. Nursing interventions include fetal monitor,
vaginal exam and ultrasound.
AROM- artificial rupture of membranes. Assess the amniotic fluid for color and odor.
Rupture membrane contraindicated in HIV and herpes.
5. Pain management – recognizing the risks and nursing interventions of regional anesthesia
(epidurals/ spinal) (biggest risk to mom is hypotension – which causes fetal decelerations, so
how do we prevent this?)
Stadol, Nubain, Demerol. What are some of the rules with systemic pain management it
given IV, given at peak of contraction, we have to document what we see on the fetal
monitor and to make sure they are not delivering soon because we don’t want it to go
directly to baby.
Risks of regional anesthesia is hypotension, we prevent this by fluids and put a wedge
under her right side so she is not flat on her back. What will we see on the fetal monitor
if mom is having hypotension? A prolonged deceleration or bradycardic events
6. Preparation for epidural anesthesia also has to be considered as a nursing responsibility.
Bolus a liter of fluids, consent, order, vital signs, CBC to look at platelets.
7. Know the reasons, risks and nursing interventions of the need for a C/section.
Previous C-section, position of the baby(transverse, beech), cord prolapse, failure of
dilate, placenta abruption/previa, late deceleration that is persistent and we can’t revert,
macrosomic baby, active herpes, HIV, uterine rupture, failure to progress, uterine
infection. Hopefully the doctor will do a low transverse incision. A vertical incision in the
uterus will make it impossible to labor so mom can’t have a vaginal birth next time(V
back).
8. Non pharmacological pain management for the laboring patient
Non pharmacological pain management would be Lamaze, aromatherapy, distractions,
jacuzzi, counter pressure, acupuncture, massage, music, anything that will help her stay
focused and keep breathing, getting her off her back taking the pressure off her pelvis
will ease the pain.
9. Review the abnormalities of labor (dysfunction labor )and the obstetrical emergencies
Placenta abruption and previa.
Shoulder dystocia, diabetics are at risk because they can have macrosomic babies and
they can have injury coming through the birth canal. We can tell this is happening when
the mother is in the second stage of labor and she is not progressing. When the doctor
tells us to we need to push on the symphysis, to free the shoulder.
This study source was downloaded by 100000832361371 from CourseHero.com on 02-17-2022 00:01:03 GMT -06:00
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller GEEKA. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.48. You're not tied to anything after your purchase.
